A 63-year-old male patient was referred to our outpatient clinic with complaints of upper and lower limbs weakness, which started progressively 5 years ago. Cervical X-ray and magnetic resonance imaging showed straitening of the cervical column in a fixed flexion position and fusion of the vertebral bodies, with diffuse type posterior longitudinal ligament ossification with secondary canal stenosis. The patient was operated with C2-T2 laminectomy. In the immediate post-operative period, the patient was conscious. However, he was unable to breath by himself with insufficient respiratory tidal volume and worsening of the weakness of the extremities. Emergency cervical computed tomography scan showed proper decompression of the cervical canal, no evidence of haemorrhage, and enlarged oedematous spinal cord. The patient was diagnosed of post-decompression reperfusion injury with secondary diaphragm paralysis. Ventilation and medical treatment were applied to manage the situation and the patient improved in his lower limbs motor power and in the tidal volume. The decision was to transfer the patient to another rehabilitation centre to continue treatment.
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